Medically Reviewed By Elizabeth Scheffel, PharmD
— Written By Alex Brewer, PharmD, MBA
Updated on June 5, 2022
Tresiba: Introduction
Tresiba is a brand-name prescription drug. It’s a type of medication called a long-acting insulin, and it contains the active drug insulin degludec. It comes as a solution and is given by subcutaneous injection.
Tresiba is approved by the Food and Drug Administration (FDA) to manage blood sugar levels in adults and children ages 1 year and older with diabetes. It’s typically used long term.
Similar to other drugs, Tresiba may cause side effects. Read below for information about possible side effects, including common, mild, and serious ones.
For a general overview of Tresiba, including details about its uses, see this article.
If you’d like to take Tresiba, search here to find a healthcare professional who might prescribe it.
Tresiba: More common side effects
Some of Tresiba’s side effects may be more common than others. These side effects may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about any side effects with Tresiba.
In Tresiba’s clinical studies, these were some side effects that occurred more often:
- cold symptoms, such as a runny or stuffy nose
- headache
- diarrhea
- low blood sugar*
- weight gain*
* For more information about this side effect, see “Tresiba: Side effects explained” below.
Tresiba: Mild side effects
Tresiba can cause mild side effects, which are listed below. However, this list doesn’t include all possible mild side effects. To learn more about Tresiba’s side effects, view the drug’s prescribing information.
Tresiba’s mild side effects include:
- cold symptoms, such as a runny or stuffy nose
- upper respiratory infection, such as the common cold
- sinus infection
- headache
- diarrhea
- injection site reactions
- swelling in the ankles, lower legs, or feet
- lipodystrophy*
- weight gain*
- stomach pain*
- mild allergic reaction*
The side effects listed above may last only a few days to weeks. However, some side effects may last longer or become severe or bothersome. Tell your doctor or pharmacist if you have concerns about side effects with Tresiba.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Tresiba and want to tell the FDA about it, visit MedWatch.
* For more information about this side effect, see “Tresiba: Side effects explained” below.
Tresiba: Serious side effects
It’s possible to have serious side effects with Tresiba. Serious side effects are listed below, but this list may not include all possibilities. To learn more about Tresiba’s side effects, view the drug’s prescribing information.
Call your doctor right away if you have serious side effects with Tresiba. However, if you think you’re having a medical emergency or life threatening side effects, call 911 or your local emergency number.
Serious side effects of Tresiba and their possible symptoms include:
- Low potassium level. Symptoms can include:
- constipation
- fatigue
- palpitations
- lightheadedness
- muscle cramps or weakness
- tingling in your hands, fingers, or toes
- Low blood sugar.*
- Severe allergic reaction.*
* For more information about this side effect, see “Tresiba: Side effects explained” below.
Tresiba: Common questions about side effects
Here are some common questions about the drug’s side effects and answers to them. Talk with your doctor if you have other questions about this drug.
Are side effects with Tresiba FlexTouch pens different from those with Tresiba vials?
No. Side effects with Tresiba FlexTouch pens are the same as those with Tresiba vials. That’s because both of these Tresiba products contain the same active drug. They’re just supplied in different containers.
To learn more about Tresiba’s side effects, see “Tresiba: Mild side effects” and “Tresiba: Serious side effects” sections above.
Talk with your doctor about which form of Tresiba is best for you.
Does Tresiba cause eye-related side effects?
No, Tresiba isn’t expected to cause eye-related side effects.
Diabetes can cause eye and vision problems. (Tresiba is used to treat diabetes.) For example, having high blood sugar levels over time can lead to diabetic eye disease.
Temporary eye problems can happen when you first start using a medication, including Tresiba, to manage blood sugar levels. This may include worsening vision. However, these eye problems typically go away with the long-term management of blood sugar levels.
Talk with your doctor if you’re concerned about your eye health and diabetes. Getting regular eye exams can help screen for eye complications caused by diabetes. Your doctor can advise you on how often you should have your eyes examined.
What are some rare side effects of Tresiba?
Some side effects that were rare compared with other side effects in Tresiba’s clinical studies include:
- swelling in the ankles, lower legs, or feet
- lipodystrophy*
- allergic reaction*
To view more information on how often these side effects occurred, check out Tresiba’s full prescribing information. You can also talk with your doctor or pharmacist to learn more.
Similar to all insulins, Tresiba may also rarely cause hypokalemia (low blood potassium levels). However, this side effect wasn’t reported in Tresiba’s clinical studies.
* For more information about this side effect, see “Tresiba: Side effects explained” below.
Is hair loss a side effect of Tresiba?
No, hair loss isn’t a side effect expected with Tresiba. This side effect wasn’t reported in the drug’s clinical studies.
However, diabetes, which Tresiba is used to treat, is known to cause hair loss. Medications that improve blood sugar levels, such as Tresiba, may lower your risk of hair loss caused by diabetes.
Talk with your doctor if you’re concerned about hair loss while using Tresiba. They can review your health history and medications to address possible causes.
Tresiba: Side effects explained
Here’s detailed information about some of Tresiba’s side effects.
Weight gain
Similar to all insulins, treatment with Tresiba can cause weight gain.
It’s not known exactly how many people reported weight gain in Tresiba’s clinical studies. However, it’s known that in clinical studies, people with type 1 diabetes using Tresiba for 52 weeks gained about 4 pounds on average. And people with type 2 diabetes using Tresiba for 52 weeks gained an average of about 6.5 pounds.
Tresiba can also cause fluid retention, which can contribute to weight gain.
Also, certain diabetes medications may cause fluid retention, weight gain, and rarely heart failure if they’re used in combination with Tresiba. For more information, see the “Tresiba: Precautions” section below.
What to do
Talk with your doctor if you notice weight gain that is bothersome to you while using Tresiba. They can recommend ways to manage a body weight that’s healthy for you.
If you’re taking Tresiba in combination with other medications and notice weight gain, let your doctor know. They can determine if the weight gain is related to a more serious issue.
Stomach pain
Treatment with Tresiba can cause stomach pain. This is because Tresiba can cause inflammation in your stomach, which can lead to swelling and pain.
However, this side effect wasn’t common in the drug’s clinical studies. And it was only reported by people with type 1 diabetes. This side effect may go away on its own after a few hours or days.
What to do
Let your doctor know if you have stomach pain that bothers you or doesn’t go away while using Tresiba. They may suggest a treatment to relieve your stomach pain. However, if this side effect doesn’t go away, they may suggest stopping Tresiba and trying another treatment for managing your blood sugar.
Low blood sugar
Hypoglycemia (low blood sugar) is the most common side effect of all insulins, including Tresiba. Since the drug is prescribed to lower blood sugar levels, this side effect isn’t unexpected. Blood sugar levels can be too high, but they can also be too low.
Symptoms of mild low blood sugar can include:
- blurry vision
- feeling dizzy or weak
- sweating more than usual
- irregular heartbeat
- feeling excessively hungry or thirsty
- feeling irritable or anxious
Rarely, low blood sugar can also be severe. If blood sugar levels drop too low, it can even be life threatening. Symptoms of severe low blood sugar may include:
- inability to focus on or complete simple tasks
- loss of consciousness
- inability to eat or drink
- seizures, in severe cases
What to do
Before you begin using Tresiba, talk with your doctor about a plan for monitoring your blood sugar levels. They can also suggest what to do if your levels are too low.
Below is some general advice for addressing low blood sugar, but always follow the directions given by your doctor.
Treating low blood sugar levels
If you think you’re having symptoms of mild low blood sugar, you may treat it by eating or drinking at least 15 grams (g) of glucose (simple sugar). Some examples include:
- three to four glucose tablets, which can be purchased at your pharmacy
- half a cup of fruit juice, such as orange or apple juice
- half a cup of non-diet soda that contains at least 15 g of sugar
- 1 tablespoon of sugar or honey
Check your blood sugar after about 15 minutes. If it’s still too low, give yourself another serving of 15 g of glucose and call your doctor.
If you notice symptoms of severe low blood sugar, immediately call 911 or your local emergency number. You can also have someone take you to the nearest emergency room. (Do not attempt to drive if you have symptoms of severe low blood sugar.)
People who have low blood sugar are typically able to continue using Tresiba. However, your doctor may adjust your dose.
Preventing low blood sugar levels
These tips may help prevent low blood sugar levels while you’re using Tresiba:
- Do your best to avoid skipping or delaying meals. Skipping meals can cause your blood sugar levels to drop.
- Eat a small snack, such as yogurt, peanut butter, or a banana, before you exercise.
- Work with a dietitian or another healthcare professional to make sure your carbohydrate intake aligns with your diabetes treatment plan, including your Tresiba dose.
Lipodystrophy
Tresiba can cause lipodystrophy as a side effect. However, this side effect wasn’t common in the drug’s clinical studies.
With lipodystrophy, your skin thickens or develops pits at the sites where Tresiba is injected. This happens because Tresiba injections can change how your body stores fat under your skin.
What to do
To help prevent lipodystrophy, you can rotate the site where you inject Tresiba with each dose. Tresiba is given by subcutaneous injection into your abdomen, thigh, or upper arm. You should avoid injecting Tresiba into skin that is lumpy, indented, pitted, or thickened.
Let your doctor know if you develop lipodystrophy while using Tresiba. This side effect often goes away on its own if you avoid injecting Tresiba into the affected area. However, your doctor may suggest other ways to address this side effect. Or they may suggest stopping Tresiba and switching to another medication.
Allergic reaction
As with most drugs, some people can have an allergic reaction after taking Tresiba. A more severe allergic reaction is rare but possible. Allergic reactions weren’t common in Tresiba’s clinical studies.
Possible symptoms of mild and serious allergic reactions are listed in the table below.
| Mild allergic reaction symptoms | Serious allergic reaction symptoms |
| • itching | • trouble breathing |
| • rash | • swelling in your throat or mouth |
| • flushing | • swelling under your skin, possibly in your hands, feet, lips, or eyelids |
If you have an allergic reaction to Tresiba, call your doctor right away. This is important to do because the reaction could become severe.
However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.
Tresiba: Precautions
Be sure to talk with your doctor about your health history before you take Tresiba. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health.
The conditions and factors to consider include those described below.
Liver or kidney problems. If you have liver or kidney problems, you may be at higher risk of hypoglycemia (low blood sugar). Low blood sugar is the most common side effect Tresiba may cause. It’s usually safe for people with liver or kidney problems to use Tresiba. However, your doctor may decide to prescribe a lower dose for you. They may also suggest monitoring your blood sugar closely while you’re using Tresiba.
Hypokalemia (low blood potassium level). Similar to all insulins, Tresiba may cause hypokalemia. If you already have hypokalemia, using Tresiba may worsen your condition. Your doctor may choose to treat your low potassium level before prescribing Tresiba. Or they may choose to closely monitor your potassium levels during treatment with Tresiba.
Heart failure. Tresiba may cause fluid retention. In someone with heart failure, fluid retention can worsen their condition. And if you have heart failure and take thiazolidinediones such as pioglitazone (Actos), using Tresiba may greatly increase the risk of worsened heart failure. (Thiazolidinediones are another type of diabetes medication.) For this reason, it’s important to let your doctor know if you have heart failure before you start using Tresiba. You should also let them know about all medications you take, including any other medications for diabetes. If your heart failure symptoms get worse, your doctor may have you stop taking the thiazolidinedione while you’re using Tresiba.
Allergic reaction. If you’ve had an allergic reaction to Tresiba or any of its ingredients, your doctor will likely not prescribe Tresiba. Ask your doctor what other medications may be better options for you.
Consuming alcohol during Tresiba treatment
It’s best to moderate or minimize alcohol consumption if you’re using Tresiba.
Both alcohol and Tresiba can lower your blood sugar levels. Combining the two can raise your risk of hypoglycemia (low blood sugar), including severe hypoglycemia.
For this reason, talk with your doctor if you consume alcohol and are prescribed Tresiba. Your doctor can tell you how much, if any, alcohol is safe to drink while you’re using Tresiba.
Pregnancy and breastfeeding during Tresiba treatment
Tresiba hasn’t been studied in pregnant people. However, insulin, including Tresiba, is the preferred treatment for managing blood sugar levels during pregnancy, according to the American Diabetes Association.
Additionally, insulin, including Tresiba, is
If you’re pregnant, breastfeeding, or planning either, talk with your doctor They can review the risks and benefits of all possible options with you.
Tresiba: What to discuss with your doctor
Talk with your doctor or pharmacist to find out more information about Tresiba. If you have questions about the drug’s side effects, your pharmacist or healthcare professional can help answer them for you.
In addition to discussing Tresiba with your doctor, you may find the following articles helpful in learning more.
- Overview of Tresiba. To read an overview of Tresiba, see this article.
- Drug comparison. To learn how Tresiba compares with Lantus, read this article.
- Details about diabetes. To learn more about diabetes, which Tresiba is used to treat, see this article.
Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
